Dec. 5, 2004

Brian Dallas, ATC-L
Graduate Assistant Athletic Trainer
North Carolina State University

The field of athletic training has many job responsibilities within an athletic department, all of which are directly or indirectly related to helping athletes perform at their optimal level of performance. For a wrestling team, there is no better way to get an athlete in proper shape and condition than to bring them into a wrestling room and let them "have at it" with teammates. In order to help these athletes perform, it is necessary to limit the amount of days away from practice, especially when an injury occurs.

Herpes gladiatorum and tinea corporis, otherwise know as ringworm, are the two major skin infections that require time away from the wrestling room. They are both common with collegiate wrestlers due to the direct skin-to-skin contact between an infected wrestler and a noninfected wrestler. In order to help reduce the likelihood of athletes contracting these skin lesions, there must be cooperation between all involved within the sport of wrestling.

Herpes gladiaorium (HG) is caused by a virus, herpes simplex I. The virus is highly contagious through direct skin contact with the lesions. Any area of broken skin is particularly vulnerable. The most common sites for contracting HG are the neck, face and arms. The skin lesion is one of a group of small blisters called vesicles on a base of reddened skin. Many times these lesions are accompanied by other symptoms such as sore throat, fever, fatigue and swollen gums. While the skin lesions are acute, the wrestler may not participate and the lesions should not be touched without wearing protective gloves. The athlete may wrestle when all scabs have dried and there is pink skin.

Herpetic skin lesions can heal without medication. However, an antiviral medicine such as Acyclovir can speed up the healing course and greatly reduce the ability to be contagious. Because HG is an incurable disease with common recurrences, team physicians will sometimes prescribe prophylactic medication, meaning an athlete will begin taking medications even though there is no current outbreak, thus reducing the risk of outbreaks occurring during the season.

Tinea infections are much more common. They are caused by a fungus. Common areas to see tinea are the neck and arms. Typical lesions have a raised border and are often in a circular pattern. Redness is variable. Usually inside the border is less pronounced. There is some fine scale but no itching. There may be multiple lesions or a single one.

Tinea corporis has different treatment options once diagnosed. A physician has the option of using an oral medication or topical antifungal cream. Creams are sometimes used when only one lesion is seen on the body.

Athletes need to get prompt medical attention for any wounds or skin injuries.

For more than one lesion or resistant lesions, physicians may prescribe an oral antifungal agent. Unfortunately, no one really knows how long an athlete has to be treated to become noninfectious. For single lesions, a covering may be applied to the area permitting competition as long as it can stay covered through competition.

Prevention is the key to effectively combating skin infections in wrestling. It takes a team effort to be successful. Let's look at all the groups involved.

Athletes
The athlete needs to maintain proper hygiene. This means frequent showering and having one's fingernails cut short and cleaned daily. The athlete needs to get their practice gear laundered daily. They should have gear, designed specifically for their training. This is extremely important, as it has been seen that some clothing, like cotton and polyester mixtures, may be more abrasive than others, thus opening the door to bacterial growth. They need to get prompt medical attention for any wounds or skin injuries. If the athlete is taking preventative medication for skin infections, it should be taken as directed.

Coaching Staff
The wrestling coaching staff takes a large amount of control with helping their athletes to become educated about the proper maintenance of their body during a wrestling season. Education regarding the proper maintenance of the wrestler's body is imperative for the coaching staff. Not only are they responsible for the conditioning work of their athletes but also for the education of proper cleansing and hygiene that must happen on a daily basis. With the careful teamwork of coaches and athletic trainers, the identification of common skin lesions can be quickly and properly managed.

It's the coach's responsibility for proper upkeep of the wrestling area and equipment. This means making sure that all mats are properly taped down to the floor, and any cuts or openings in the mat are cleaned and covered to prevent bacteria formation. Due to the coach's relationship with his athletes, it also becomes his responsibility to make sure team members are mopping the mats at least once a day.

Custodial Staff
After all of the athletes, sports medicine, and athletic staff have left the building, another support group for the athletic department, the custodial staff, is just about to begin their work. The custodial staff is not just responsible for the upkeep of bathrooms within the building, but also the daily cleaning and maintenance of the whole facility. Some of their responsibilities include the daily vacuuming and cleaning of the wrestling locker room and shower facilities, where some bacterial agents are known to thrive.

Physicians
Once an athlete has been assessed as having any kind of skin lesion, it becomes the responsibility of the athletic trainer to make sure they are seen and treated by a physician before returning to activity. With the help of team physicians this duty can be quick and effortless. With the help of doctor visits on campus, an athlete is able to receive proper diagnosis and treatment promptly.

Certified Athletic Trainers
The team athletic trainer is involved with many issues regarding skin lesions because of their knowledge and supplies for proper maintenance of all athletic injuries. It is the responsibility of the athletic trainer to detect and assess any skin lesion(s) found on an athlete, by performing daily skin checks of all exposed body parts. It is then the responsibility of the athletic trainer to make sure that these lesions are properly referred for diagnoses and treatment to a team physician.

NCAA wrestling and sports medicine has certain rules that all athletic trainers must follow when allowing athletes to compete with any type of skin lesions. It is the responsibility of each teams' athletic trainer to make sure that these rules and regulations are being followed to help not only their athletes, but those they compete against.

In order to help protect athletes from coming in contact with these diseases, there are many options that the athletic trainer can attempt. First they may require that all athletes prior to competition or practice apply a skin protection lotion (Ken shield for example). These lotions are applied to any exposed skin just prior to competition and can help protect athletes from some of the bacterial infections that occur.

If any medications are prescribed for the athlete to take after a medical diagnosis has been reached, it is sometimes the responsibility of the athletic trainer to make sure an athlete is able to obtain and finish them. The athletic trainer also helps to make sure that there are no negative reactions to the medications.

As the wrestling team athletic trainer, it is my responsibility to make sure that the different team members are completing all of these steps. Acting as the median between different groups helps to create a clear communication between team members and helps make sure that all members are working towards the same common goal: to protect all athletes from these diseases.

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